CHAPTER ONE INTRODUCTION BACKGROUND TO THE STUDY

Health care is dependent on information and to strengthen quality healthcare delivery in any country, is to improve health information system. Healthcare quality extend beyond just meeting client satisfaction, but addresses other components which includes effectiveness, efficiency, equity, safety and timeliness is service delivery (Lohr, 1990). In recent years, aside the need to deliver quality healthcare in a competitive market, managers of health facilities have been overwhelmed with very complex financing, purchasing and provision of health services. This volatile healthcare environment has led to the acknowledgement of the importance of adopting Information Technologies like the Electronic Health Records (EHR) in healthcare management.

Electronic Health Records (EHR) is an electronic version of a patient’s health record that was historically created, used, and stored in a paper chart. This is generated, managed, and kept by a healthcare organisation (Roman, 2009). Electronic Health Records (EHR) are poised to change and revolutionise modern healthcare system in the world. The surge in the development of Information Technologies (ITs) provide various tailor-made innovative applications and systems known as Electronic Health Record system (EHRs). It is assumed to improve cost efficiency, safety, and the quality of healthcare services, however, the adoption of Electronic Health Record systems (EHRs) has been slow to catch on with healthcare providers. Governments have made efforts to promote the digitisation of the health industry by introducing measures or policies to promote what is known as e-health. In developed countries, EHR’s are becoming a necessary component of healthcare. For example, the U.K. and Sweden have national EHRs, the United State passed legislation requesting all healthcare providers to adopt and use EHR by 2015 (Tom , Dean , & Tod , 2014). Other countries like

Australia, Netherlands, New Zealand, Italy and Norway are rate 90% plus, Germany and France rated 72% and 68% respectively, in the coverage of EHRs (Silversides, 2009).

Consequently, the adoption of EHR in sub-Saharan Africa has increased over the last 10 years, initially driven by international efforts at controlling the HIV/AIDS epidemic, although public health institutions in the region appear to be slow adopting EHR and other relevant ITs which are required to improve healthcare (Maxwell, et al., 2012). Acknowledging the potentials of EHR, the World Health Organization (WHO) published a manual on implementing EHRs for developing countries to guide to agencies intend to fund e-health projects. Despite efforts made by these agencies, Sub-Sahara Africa is still faced with many daunting challenges in the adoption of these systems. Among other challenges mentioned include, financing the immense cost of setting up EHR systems or infrastructure, lack of support from government and other stakeholders. In contrast, countries like South Africa, Cameroon among others experienced high failure in the process of adopting EHRs despite support from government and agencies. This on the other hand, failure were attributed to factors such as social influence user perception, system is too difficult to use and lack of training (Arman & Hartati, 2015).

In Ghana, as in most African countries, availability of good quality data for decision making remains a great challenge. The government of Ghana therefore launched the national e-health strategy in in July, 2010 with a list of key strategies to promote the use health information systems, key of which is the EHRs. After the launch of e-health, other different software applications were purchased by some private and large public hospitals to setup EHRs. These EHR systems are tailored towards widening the capacity to support the complete processes in the hospitals – from clinical to purchasing and/ procurement (Achampong E. K., 2012).

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